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Based on review of facility documentation, non-hospital ambulance transport log documentation, observation, and staff interviews (EMP), it was determined the facility failed to comply with 489.24 related to Medical Screening Examination.

Findings include:

The review of facility documentation, non-hospital ambulance transport log documentation, observation, and staff interviews (EMP) revealed the facility failed to ensure an appropriate medical screening examination (MSE) to a patient who was on hospital property was completed in one of 23 medical records reviewed (MR23).

Cross reference with:
489.24(a) and 489.24(c) - Medical Screening Exam

Based on review of facility documents, surveillance video and staff interviews (EMP), it was determined that the facility failed to ensure that an individual who came to their Emergency Department seeking assistance, was entered onto the Emergency Central Log for one of 23 medical records reviewed (MR23).

Findings Include:

Review on September 19, 2023, of the facility policy, "EMTALA (Emergency Medical Treatment And Active Labor Act)" - Administrative effective September 2023, revealed "Scope and Purpose -To ensure compliance with the federal Emergency Medical Treatment and Active Labor Act (EMTALA) (42 U.S.C. § 1395dd) related to the treatment and stabilization of patients with Emergency Medical Conditions, the availability and response of on-call physicians, the transfer of patients, the reporting of inappropriate transfers, the maintenance of an Emergency Central Log and other related requirements ... Policy And Procedure Statements Emergency Central Log a comprehensive record maintained of all individuals who come to Lancaster Medical Center seeking emergency care. The Emergency Central Log includes patient logs from the emergency department as well as those patient logs from any other areas of Lancaster Medical Center that provide emergency care ..."

Review on September 19, 2023, of security camera footage revealed at approximately 17:51, on September 9, 2023, the patient is transported via ambulance stretcher by Emergency Medical Services into the facility Emergency Department (ED). The patient and EMTs (Emergency Medical Technicians) are met at end of the entrance hallway in front of nurse's station by a staff member at 17:52. This staff person (later identified as a physician) spoke to the patient and EMT staff from 17:52-17:56, and then patient's stretcher is turned around taking the patient back out of the hospital.

Interview with EMP2 on September 19, 2023, EMP2 confirmed MR23 was not entered onto the facility's Emergency Central Log on September 9, 2023.

Based on review of facility documents, security surveillance, and staff interview (EMP) it was determined the facility failed to provide a medical screening exam for a patient (MR23) who arrived at the facility via ambulance for one of one observation made.

Findings include:

Review on September 19, 2023, of the facility policy, "EMTALA (Emergency Medical Treatment And Active Labor Act)" - Administrative effective September 2023, revealed "Scope and Purpose-To ensure compliance with the federal Emergency Medical Treatment and Active Labor Act (EMTALA) (42 U.S.C. § 1395dd) related to the treatment and stabilization of patients with Emergency Medical Conditions, the availability and response of on-call physicians, the transfer of patients, the reporting of inappropriate transfers, the maintenance of an Emergency Central Log and other related requirements. EMTALA requires Medicare-participating hospitals with emergency departments to screen and treat the emergency medical conditions of patients in a non-discriminatory manner, regardless of their ability to pay, insurance status, national origin, race, creed or color. ... In compliance with EMTALA, the Emergency Medical Treatment and Labor Act, Lancaster Medical Center's dedicated emergency departments (DED) will offer emergency medical care, as indicated by an individual's medical condition, to all individuals arriving at LMC for emergency examination or treatment without regard to the individual's insurance status. This applies to anyone who seeks emergency medical treatment and is on hospital property at LMC including patients who are transferred to LMC in accordance with the provisions of any LMC transfer agreements that are in effect. ... The EMTALA obligation exists when the following occurs: ... 4. The patient is in a non-hospital owned ambulance that has arrived on hospital property for examination and treatment on a medical condition at the hospital's DED ..."

Request on September 19, 2023, for patient medical record and medical screening exam but none was provided.

Review on September 19, 2023, of security camera footage revealed at approximately 17:51, on September 9, 2023, the patient is transported via ambulance stretcher by Emergency Medical Services into the facility Emergency Department (ED). The patient and EMTs (Emergency Medical Technicians) are met at end of the entrance hallway in front of nurse's station by a staff member at 17:52. This staff person (later identified as a physician) spoke to the patient and EMT staff from 17:52-17:56, and then patient's stretcher is turned around taking the patient back out of the hospital.


Interview on September 19, 2023, at approximately 10:38 AM with EMP1 confirmed the reviewed security camera footage was of MR23 and there was no medical screen exam documented.